Reddenda · Rate Intelligence · National

What payers pay, by CPT code

Reddenda indexes the contracted rates commercial payers publish for 195 of the highest-volume CPT codes. For each code, see the observed national rate distribution across payer filings, from the 25th to the 90th percentile, built from federal Transparency-in-Coverage data joined to the CMS Medicare Physician Fee Schedule. Documented from public rates, modeled and not guaranteed.

Want your own rate against local peers, per payer and per code? Enter your NPI for a free RateScore. About 15 seconds, no card, no PHI.

Run a free RateScore on your NPI → Compare a code across states & payers

Office visits & evaluation (E/M) (26)

CPT 99214 · Office visit, established patient, 30-39 min median $127.94
CPT 99213 · Office visit, established patient, 20-29 min median $92.75
CPT 99204 · Office visit, new patient, 45-59 min median $180.91
CPT 99212 · Office visit, established patient, 10-19 min median $52.81
CPT 99203 · Office visit, new patient, 30-44 min median $116.74
CPT 99211 · Office visit, established patient, minimal median $22.24
CPT 99215 · Office visit, established patient, 40-54 min median $185.97
CPT 99396 · Preventive visit, established pt, age 40-64 median $137.31
CPT 99385 · Preventive visit, new pt, age 18-39 median $144.94
CPT 99283 · Emergency dept visit, level 3 median $91.78
CPT 99291 · Critical care, first 30-74 min median $320.69
CPT 99284 · Emergency dept visit, level 4 median $159.79
CPT 99285 · Emergency dept visit, level 5 median $235.60
CPT 99395 · Preventive visit, established pt, age 18-39 median $127.25
CPT 99282 · Emergency dept visit, level 2 median $54.88
CPT 99292 · Critical care, each additional 30 min median $146.72
CPT 99394 · Preventive visit, established pt, age 12-17 median $126.26
CPT 99384 · Preventive visit, new pt, age 12-17 median $153.05
CPT 99383 · Preventive visit, new pt, age 5-11 median $132.53
CPT 99392 · Preventive visit, established pt, age 1-4 median $110.92
CPT 99391 · Preventive visit, established pt, infant median $108.99
CPT 99397 · Preventive visit, established pt, 65+ median $148.83
CPT 99281 · Emergency dept visit, level 1 median $20.47
CPT 99393 · Preventive visit, established pt, age 5-11 median $111.52
CPT 99381 · Preventive visit, new pt, infant median $123.89
CPT 99382 · Preventive visit, new pt, age 1-4 median $131.66

Imaging & radiology (7)

CPT 73610 · X-ray, ankle, 3+ views median $37.44
CPT 72110 · X-ray, lumbar spine, 4+ views median $53.59
CPT 73562 · X-ray, knee, 3 views median $42.68
CPT 72100 · X-ray, lumbar spine, 2-3 views median $40.22
CPT 73501 median $32.34
CPT 73721 · MRI, lower extremity joint, w/o contrast median $234.26
CPT 76872 median $170.82

Surgery & procedures (70)

CPT 27447 median $1,773.60
CPT 23472 median $1,984.75
CPT 29827 · Shoulder arthroscopy, rotator cuff repair median $1,474.28
CPT 28296 median $816.57
CPT 45378 · Diagnostic colonoscopy median $321.28
CPT 20610 · Major joint injection (shoulder, hip, knee) median $78.50
CPT 20605 · Aspiration/injection, intermediate joint median $66.35
CPT 17110 · Destruction, benign lesions, up to 14 median $108.84
CPT 20550 · Tendon sheath/ligament injection median $66.90
CPT 10060 · Incision and drainage of abscess, simple median $145.92
CPT 27502 median $1,110.95
CPT 20600 · Aspiration/injection, small joint (e.g., finger) median $63.67
CPT 10061 · Incision and drainage of abscess, complex median $253.78
CPT 17000 · Destruction, premalignant lesions, first median $75.86
CPT 64612 median $190.11
CPT 11900 median $52.51
CPT 45380 · Colonoscopy w/ biopsy median $378.41
CPT 20551 · Tendon origin/insertion injection median $61.68
CPT 29881 · Knee arthroscopy w/ meniscectomy median $818.74
CPT 28285 median $620
CPT 12001 · Simple wound repair, ≤2.5cm median $89.16
CPT 43239 · EGD w/ biopsy median $318.55
CPT 17111 · Destruction, benign lesions, 15+ median $124.60
CPT 45385 · Colonoscopy w/ polyp removal (snare) median $470.47
CPT 11730 · Avulsion of nail plate, single median $93.39
CPT 64483 · Lumbar epidural injection, single level median $218.88
CPT 12011 · Simple repair, face/lip/eyelid, ≤2.5cm median $108.68
CPT 11055 · Paring of corn or callus, single median $31.99
CPT 11720 · Debridement of nails, 1-5 median $28.29
CPT 11721 · Debridement of nails, 6+ median $46.21
CPT 17003 · Destruction, lesions 2-14, each median $4.66
CPT 36415 · Routine venipuncture median $6.72
CPT 64484 · Lumbar epidural injection, each additional median $98.15
CPT 11300 · Shaving lesion, trunk/arms/legs, ≤0.5cm median $64.29
CPT 43235 · EGD, diagnostic median $270.03
CPT 11901 median $69.84
CPT 11301 · Shaving lesion, trunk/arms/legs, 0.6-1cm median $92.36
CPT 27500 · Closed treatment of femoral shaft fracture median $716.55
CPT 11732 · Avulsion of nail plate, each additional median $35.41
CPT 11056 median $44.98
CPT 11306 · Shaving lesion, scalp/neck/hands/feet, 0.6-1cm median $93.30
CPT 11305 · Shaving lesion, scalp/neck/hands/feet, ≤0.5cm median $73.29
CPT 20611 · Major joint injection w/ ultrasound guidance median $113
CPT 45384 · Colonoscopy w/ tumor removal, hot biopsy median $413.74
CPT 11057 median $56.13
CPT 52000 · Cystoscopy median $181.85
CPT 64635 · Lumbar facet RFA, single level median $405.74
CPT 51700 median $67.20
CPT 45379 median $420.72
CPT 28470 · Closed treatment of metatarsal fracture median $291.57
CPT 52310 · Cystoscopy w/ stent removal median $303.97
CPT 55706 median $514.58
CPT 64493 · Facet joint injection, lumbar, single level median $179.41
CPT 51701 median $47.53
CPT 64633 · Cervical/thoracic facet RFA, single level median $404.71
CPT 43245 · EGD w/ dilation gastric outlet median $392.66
CPT 45386 · Colonoscopy w/ balloon dilation median $382.94
CPT 52315 median $486.34
CPT 53600 median $100.47
CPT 64636 · Lumbar facet RFA, each additional median $120.41
CPT 64494 · Facet joint injection, lumbar, second level median $98.59
CPT 53601 median $84.77
CPT 64491 · Facet joint injection, cervical/thoracic, second median $114.69
CPT 64490 · Facet joint injection, cervical/thoracic, single median $207.33
CPT 64495 · Facet joint injection, lumbar, third+ level median $99
CPT 64634 · Cervical/thoracic facet RFA, each additional median $132.98
CPT 43257 median $339.25
CPT 62323 · Lumbar epidural injection w/ imaging guidance median $197.28
CPT 62321 · Cervical/thoracic epidural injection median $208.15
CPT 55700 · Prostate biopsy, needle median $330.41

Lab & pathology (4)

CPT 82947 · Glucose, quantitative median $3.54
CPT 80053 · Comprehensive metabolic panel median $9.50
CPT 85025 · CBC w/ differential, automated median $6.99
CPT 80061 · Lipid panel median $11.85

Medicine & procedures (73)

CPT 92250 · Fundus photography median $39.68
CPT 95886 · Complete needle EMG median $89.19
CPT 92083 · Visual field exam, extended median $62.10
CPT 92081 · Visual field exam, limited median $33.28
CPT 93306 · Transthoracic echocardiogram, complete median $202.16
CPT 93971 · Extremity venous duplex, limited or unilateral median $124.24
CPT 93308 median $102.10
CPT 93970 · Extremity venous duplex, complete bilateral median $190.40
CPT 93880 · Carotid duplex ultrasound, complete median $197.34
CPT 95816 · EEG, awake & drowsy median $354.38
CPT 91010 median $213.88
CPT 95909 · Nerve conduction studies, 5-6 studies median $124.39
CPT 95819 · EEG, awake & asleep median $417.03
CPT 95908 · Nerve conduction studies, 3-4 studies median $105.08
CPT 93307 · Transthoracic echo, w/o spectral Doppler median $136.89
CPT 95907 · Nerve conduction studies, 1-2 studies median $82.54
CPT 95810 median $599.33
CPT 93350 · Stress echocardiogram median $180.28
CPT 93882 median $130.81
CPT 95811 median $627.23
CPT 97110 · Therapeutic exercise, 15 minutes median $31.35
CPT 97150 · Group therapeutic procedures median $18.93
CPT 97163 · PT evaluation, high complexity median $101.44
CPT 92100 median $72.22
CPT 97164 · PT re-evaluation median $71.40
CPT 97763 median $58.66
CPT 97112 · Neuromuscular reeducation, 15 minutes median $34.85
CPT 97140 · Manual therapy techniques, 15 minutes median $29.26
CPT 97750 · Physical performance test median $36.06
CPT 97165 · OT evaluation, low complexity median $102.45
CPT 97166 · OT evaluation, moderate complexity median $102.45
CPT 97530 · Therapeutic activities, 15 min median $37.95
CPT 97167 · OT evaluation, high complexity median $102.45
CPT 97168 · OT re-evaluation median $70.77
CPT 97035 · Ultrasound therapy, 15 minutes median $15.14
CPT 97124 · Massage therapy, 15 min median $28.18
CPT 97116 · Gait training therapy median $31.87
CPT 97014 · Electrical stimulation, unattended median $14.80
CPT 93000 · Electrocardiogram, complete median $22.90
CPT 97026 · Infrared therapy median $7.16
CPT 93798 median $26
CPT 90837 · Psychotherapy, 60 minutes median $171.77
CPT 90792 · Psychiatric diagnostic eval w/ medical median $223.62
CPT 97761 median $42.44
CPT 93010 · ECG, interpretation only median $11.68
CPT 93040 median $18.36
CPT 97162 · PT evaluation, moderate complexity median $101.44
CPT 90834 · Psychotherapy, 45 minutes median $120.47
CPT 90791 · Psychiatric diagnostic evaluation median $195.01
CPT 97012 · Mechanical traction median $16.65
CPT 97760 · Orthotic management & training median $50.89
CPT 97535 · Self-care management training, 15 min median $34.32
CPT 97161 · PT evaluation, low complexity median $101.44
CPT 90847 · Family psychotherapy with patient, 50 min median $131.10
CPT 90832 · Psychotherapy, 30 minutes median $90.24
CPT 98943 · Chiropractic manipulative treatment, extraspinal median $26.21
CPT 93042 median $9.95
CPT 92014 · Eye exam, established patient, comprehensive median $108
CPT 98941 · Chiropractic manipulative treatment, 3-4 spinal regions median $38.73
CPT 92004 · Eye exam, new patient, comprehensive median $124.39
CPT 96136 · Test administration, first 30 min median $44.68
CPT 92012 · Eye exam, established patient, intermediate median $71.17
CPT 98942 · Chiropractic manipulative treatment, 5 spinal regions median $50.11
CPT 90853 · Group psychotherapy median $36.54
CPT 90846 · Family psychotherapy w/o patient, 50 min median $128.54
CPT 98940 · Chiropractic manipulative treatment, 1-2 spinal regions median $27.21
CPT 96116 median $115.50
CPT 92002 · Eye exam, new patient, intermediate median $78
CPT 96138 · Test administration by technician, first 30 min median $47.07
CPT 90460 · Vaccine admin, first/only component, age <19 median $27.85
CPT 90839 · Crisis psychotherapy, first 60 min median $173.62
CPT 90840 · Crisis psychotherapy, each additional 30 min median $85.40
CPT 90461 · Vaccine admin, each additional component median $13

Other codes (15)

CPT E0135 median $34.50
CPT E0601 median $247.70
CPT E0114 median $32.84
CPT E0116 median $19.76
CPT E0130 median $34.41
CPT K0002 median $292.67
CPT K0001 median $166.50
CPT K0003 median $249.17
CPT L1906 median $112.46
CPT L3020 median $193.66
CPT A4253 median $7.49
CPT A4259 median $1.21
CPT A4570 median $13.77
CPT A9900 median $50
CPT E1399 median $50

Observed distribution across payer filings nationally, modeled from public rates and never guaranteed. Not a local peer median or a RateScore (those measure a specific provider against its local peers).